Parenting & Children's Health Data Verified

Reye’s Syndrome - Causes, Symptoms, Pathophysiology, Diagnosis, and Treatment

Published on Nov 25, 2020 and last reviewed on Nov 27, 2020   -  5 min read

Abstract

Reye's syndrome commonly affects children recovering from a viral infection. Read about its causes, symptoms, pathophysiology, diagnosis, and treatment.

Contents
Reye’s Syndrome - Causes, Symptoms, Pathophysiology, Diagnosis, and Treatment

Introduction:

Reye's or Reye syndrome is a severe condition that usually results in liver and brain swelling but can affect any organ in the body. It is a rare condition that commonly affects children recovering from a viral infection, such as the flu. The use of Aspirin is believed to be the cause, so avoid giving Aspirin to children or teenagers for fever or headache. If your child develops confusion, loss of consciousness, or seizures, get to the emergency room immediately. The child’s life can be saved by diagnosing and treating this condition early.

An Australian pathologist R. Douglas Reye was the first person to describe this syndrome in 1963, hence the name Reye’s syndrome. The use of Aspirin is approved for children above 3 years old, but do not give it to children and teenagers when they are recovering from a viral infection. In case your child has fever or pain, Paracetamol (Acetaminophen) or Ibuprofen are safer options. Always consult your child’s pediatrician before giving him or her any medicine.

What Is Believed to Be the Cause of Reye’s Syndrome?

The cause of Reye's syndrome is still not clear. But, researchers have identified some factors that are linked to this syndrome. It was observed that children who were treated with Aspirin for fever and pain associated with viral infections, especially chickenpox and flu, developed this syndrome.

It was also noticed that children and teenagers with fatty acid oxidation disorders, which is a group of hereditary metabolic disorders where the enzyme required to break down fatty acids is either missing or not functioning properly, were also affected more when given Aspirin.

Many infectious diseases have been linked to Reye’s syndrome. The viruses that increase the risk of Reye’s syndrome are:

  1. Influenza A and B.

  2. Varicella.

  3. Parainfluenza.

  4. Measles.

  5. Adenoviruses.

  6. HIV (human immunodeficiency virus).

  7. Hepatitis A and B.

  8. Rotavirus.

  9. Coxsackie viruses.

  10. Cytomegalovirus.

  11. Epstein–Barr virus.

And infection caused by the following bacteria might also increase the risk:

  1. Mycoplasma.

  2. Shigella.

  3. Salmonella.

  4. Chlamydia.

This is an extremely rare condition, and the survival rate is around 80 %.

Pathophysiology of Reye’s Syndrome:

Mitochondrial injury is thought to be the cause. When the mitochondria (the powerhouse of a cell) gets damaged, it inhibits oxidative phosphorylation and fatty-acid beta-oxidation. This might lead to the accumulation of ammonia, which results in the levels of ammonia and acidity in the blood to rise. The child’s blood sugar level might also drop. It also causes the brain and liver to swell up. The liver of deceased children appears fatty and mitochondrial changes can be appreciated. The brain shows edema and other similar findings.

The salicylates present in Aspirin can damage the mitochondria, which gets intensified during a viral infection due to the release of endotoxins and cytokines, and leads to Reye’s syndrome. Some toxins and other medications are also said to increase the risk of this syndrome, which include:

What Are the Signs and Symptoms of Reye’s Syndrome?

The signs and symptoms of this syndrome usually start around 3 to 5 days after the symptoms of viral infection begin.

The early signs and symptoms are:

The more serious signs and symptoms include:

When to Consult a Doctor?

Parents should identify the signs and symptoms of Reye’s syndrome promptly and seek help immediately. If your child is recovering from a viral infection, such as cold, flu, or chickenpox, and if he or she exhibits the following symptoms, consult a doctor immediately:

  1. Seizures.

  2. Lose consciousness.

  3. Persistent vomiting.

How Does a Doctor Diagnose Reye’s Syndrome?

The doctor will conduct a complete physical examination and perform tests to rule out other conditions that can cause similar symptoms. The tests include:

Blood and urine tests - to detect the build-up of toxins or bacteria in the blood and to check how well the liver is functioning. They might also check for inherited metabolic disorders.

  1. CT of the Brain - to detect brain swelling.

  2. Lumbar Puncture or Spinal Tap - cerebrospinal fluid (CSF) is collected by inserting a needle with a syringe into the lower spine. This fluid is then tested for bacterial or viral infection.

  3. Liver Biopsy - a sample of the liver is checked for any liver disease.

  4. Skin Biopsy - a sample of the skin is taken to diagnose fatty acid oxidation disorders and other metabolic disorders.

Differential Diagnosis:

Reye’s disease is extremely rare, and other conditions that can result in similar symptoms include:

  1. Inherited metabolic disorders.

  2. Meningitis - the inflammation of the membranes covering the brain and spinal cord.

  3. Encephalitis - brain inflammation.

How Is Reye’s Syndrome Treated?

Reye’s syndrome is a medical emergency, which needs prompt diagnosis and treatment. The child needs to be hospitalized. There is no specific treatment or cure for this condition, as the exact cause is not known. The child will be given supportive treatment that focuses on managing the symptoms and complications. The child might need:

  1. Electrolytes and intravenous fluids to prevent dehydration and maintain electrolytes balance.

  2. Insulin is administered to increase the metabolism of glucose.

  3. Corticosteroids might be given to reduce brain swelling.

  4. Diuretics to remove excess fluid.

  5. Ammonia detoxicants to reduce the level of ammonia in the blood.

  6. The child might be put on a ventilator if he or she has breathing problems.

  7. Anticonvulsants are given to control seizures.

The doctor will closely monitor the liver and heart function. Late diagnosis of Reye’s syndrome can cause permanent brain damage and can also be fatal. Early diagnosis is crucial.

Prevention:

Even though Aspirin is approved to be used in children above 3 years of age, avoid giving it to children and teenagers for fever and pain. Also, avoid medicines that contain Aspirin in combination with other drugs.

Ask the doctor to screen your newborn baby for fatty acid oxidation disorders. If your child tests positive for this disorder, then never give them Aspirin.

Make sure you check the medicine label before asking your child to take any tablet. The other names for Aspirin are:

  1. Alka-Seltzer.

  2. Acetylsalicylic acid.

  3. Salicylic acid.

  4. Salicylate.

  5. Acetylsalicylate.

Instead of Aspirin, you can use Paracetamol (Acetaminophen) or Ibuprofen for fever and pain.

Note - Children with Kawasaki disease or other chronic diseases might need prolonged treatment with medicines that contain Aspirin. In case your child needs to take Aspirin, make sure his or her chickenpox and flu vaccine is up-to-date.

Prognosis:

The survival rate is around 80 %. Prognosis is bad if the child is in a coma. In some cases, this syndrome can result in complications like:

  1. Bad memory.

  2. Poor attention span.

  3. Partial loss of vision.

  4. Some degree of hearing loss.

  5. Speech difficulties.

  6. Movement problems.

  7. Swallowing difficulties.

For more information, consult a pediatrician online.

 

This is a sponsored Ad. icliniq or icliniq doctors do not endorse the content in the Ad.

Frequently Asked Questions


1.

What Happens in Reye's Syndrome?

Reye's syndrome is a serious condition but a rare disorder that occurs in children and adolescents. It usually occurs in children recovering from a viral infection, resulting in swelling in the liver (hepatitis) and brain (encephalopathy).

2.

Which Organs Are Affected by Reye's Syndrome?

Reye's syndrome affects many organs, but the most commonly affected organs are the liver and brain.

3.

Can Reye's Syndrome Go Away on Its Own?

Reye's syndrome cannot go away on its own because there is no cure for it, but the symptoms can be managed. Steroids can be used to reduce swelling in the brain. Experts are not sure what causes this syndrome, but the more clear evidence is that it occurs in children taking Aspirin who are recovering from a viral infection.

4.

Can Reye's Syndrome Be Fatal?

Even though most of the children and teenagers with Reye's syndrome can survive, it can also cause permanent brain damage. Without proper diagnosis and treatment, Reye's can be fatal within a few days.

5.

How Severe Is Reye's Syndrome?

Reye's syndrome is a rare but severe condition that can cause liver and brain damage. Without proper treatment, it can be fatal within a few days.

6.

Can Reye's Syndrome Spread From Person to Person?

Reye's syndrome is not a contagious disease, but it is often noticed in children recovering from viral infections like flu or chickenpox.

7.

What Is the Best Method to Prevent Reye's Syndrome?

Reye's syndrome has become less common because most doctors and parents do not give Aspirin to children who are recovering from a viral infection. It is better to give Acetaminophen (Paracetamol) or Ibuprofen if there is any pain instead of Aspirin.

8.

Can Reye's Syndrome Cause Fatty Changes in the Liver?

Reye's syndrome's most common liver-related complications are abnormal liver function, fatty deposits in the liver, and poor bleeding and clotting caused by liver failure.

9.

When Was Reye's Syndrome Discovered?

Reye's syndrome was discovered by an Australian pathologist R. Douglas Reye in 1963. Therefore it is named Reye's syndrome.

10.

How to Test for Reye's Syndrome?

The test used to diagnose Reye's syndrome are:
- Spinal tap (Lumbar puncture).
- Liver biopsy.
- Skin biopsy.
- CT (computed tomography) scan of the head.
- MRI (magnetic resonance imaging) scan of the head.

11.

What Can Be the Standard Treatment for Reye's Syndrome?

The standard treatment for Reye's syndrome usually involves hospitalization, but in severe cases, the doctor may send the children to the intensive care unit (ICU). The other treatment includes:
- Diuretics to treat increased fluid loss due to urination and intracranial pressure.
- Giving intravenous fluids like glucose and electrolytes.
- Doctors can provide medications like Vitamin K, plasma, and platelets to treat bleeding due to liver abnormalities.
- Cooling blankets can be used in patients to maintain internal body temperature.

12.

Can Adults Be Affected by Reye's Syndrome?

Reye's syndrome can occur in people of any age group, but it is most commonly seen in children and teenagers who take Aspirin while recovering from a viral infection.

Article Resources

Last reviewed at:
27 Nov 2020  -  5 min read

RATING

15

Tags:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers


In the attached file the person has white forelock and dark blue eyes. Could this be Waardenburg syndrome 2?

Query: Hello doctor, In the attached image, there can be seen as a reflection of light or white forelock. He looks to me to be between 18 and 21. His eyes are bright blue, and it cannot be seen in the picture. I am wondering if he can be diagnosed with Waardenburg syndrome 2.  Read Full »

How is dryness in and around eyes treated?

Query: Hi doctor,I suffer from dryness in and around my eyes for the past eight months. I have consulted different doctors and there is no improvement. The skin around the eyes and eyelids are dry and scaly. I have a foreign body sensation in my eyes. I have tried using eye drops over it. But there is no i...  Read Full »

I have autoimmune related sores in my mouth and bottom of lips too. Should I be worried?

Query: Hello doctor, I have got sores in my mouth which the doctor said was autoimmune related, but a week ago, I started getting what feels like sores on the inside of bottom lip and I often get pain on the back roof of the mouth, should I be worried?  Read Full »

Popular Articles Most Popular Articles

Do you have a question on Diarrhea or Vomiting?

Ask a Doctor Online

* guaranteed answer within 4 hours.

Disclaimer: Alternative medicine is not aimed to replace the services of your treating physician or allopathy medicines. Our site’s information is to those who are willing to take responsibility for their health, being fully aware that the content published herein would not qualify as prescription or specific medical advice. If users use the information and stop prescribed medication without their physician’s consent, they bear full responsibility for their actions and iCliniq bears no responsibility for the same. Information on alternative medicine should not be misinterpreted as a cure for any illness, as our body is complex and everyone reacts differently.
 

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.